Roseville Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

030000764 Issued in CA

Legal business name

ROSEVILLE SURGERY CENTER, LP

Doing business as

Roseville Surgery Center

Practice address

1420 E Roseville Pkwy
Ste 100
Roseville, CA 95661-3078

Phone

(916) 677-2488

Fax

(916) 677-2496

NPI assigned

Mar 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Boon

Title

Officer/Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Roseville Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Roseville Surgery CenterCCN 05C0001572

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1982672283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "916-677-2488",
            "fax_number": "916-677-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 E ROSEVILLE PKWY",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613078",
            "telephone_number": "916-677-2488",
            "fax_number": "916-677-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "030000764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00366559",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MEDI-CAL 05C0001572",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Roseville Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roseville Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roseville Orthopedics Group a Medical Corp
• Roseville Pain Management, Inc
• Roseville Pediatric Medical Group, Inc
• Roseville Point Health & Wellness Center LLC
• Roseville Site for Vision Products, Inc.
• Roseville Surgical Alliance Surgery Center, Inc.
• Roseville Surgical Alliance, Inc.
• Roseville Urology, Inc.
• Roseville Vision Center Inc an Optometric Corporation
• Alyssa Lorraine Rosevold, P.T.

• Ambulatory Surgical Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.